Baseline Results: The Association Between Cardiovascular Risk and Preclinical Alzheimer’s Disease Pathology (ASCEND) Study

Abstract

Background: The rate of AD for AAs is 64% higher than for non-Hispanic White Americans (Whites). It is hypothesized that poor peripheral vascular function, in combination with genetics, stress and inflammation may directly contribute to the accumulation of AD pathologic biomarkers. These risk factors may disproportionately affect AAs. Objective: Our objective was to determine if in a healthy middle-aged cohort at risk for AD (1) AD biomarkers in CSF differ by race, (2) peripheral vascular dysfunction and cognition are related to a higher burden of CSF AD biomarkers, and (3) these relationships differ by race. Methods: We enrolled 82 cognitively normal, middle-aged (45 and older) adults including AAs and Whites at high risk for AD due to parental history. Study procedures included lumbar puncture, vascular ultrasound and cognitive testing. Results: While participants were in overall good health, AAs exhibited poorer indices of preclinical vascular health, including higher central SBP, central MAP, and EndoPAT AI, a marker of arterial stiffness. AAs also had significantly less CSF tau burden than Whites. After polynomial regression analysis, adjusted for age, gender, education, and ApoE4 status, race significantly modified the relationship between total tau, phospho-tau and Trails b, a marker of executive function. Small differences in tau correlated with poorer cognition in AAs. Conclusion: In a healthy middle-aged cohort at risk for AD, AAs had worse peripheral vascular health and worse cognition than Whites. Despite lower tau burden overall, race modified the relationship between tau and cognition, such that small differences in tau between AAs was related to worse cognition when compared to Whites.

Association between Very Low-Density Lipoprotein Cholesterol (VLDL-C) and Carotid Intima-Media Thickness in Postmenopausal Women Without Overt Cardiovascular Disease and on LDL-C Target Levels

“…Since subclinical atherosclerosis interfere with future clinical CVD and physical/cognitive functioning, the potential effect of modifiable health behaviors on subclinical atherosclerosis in midlife and early postmenopausal women warrants further investigation, as it may be a critical window of opportunity for prevention [31][32][33].…”

Higher CSF sTNFR1-related proteins associate with better prognosis in very early Alzheimer’s disease

“…Participants in this study were recruited from the Emory Cognitive Neurology Clinic, Emory Alzheimer’s Disease Research Center, or community events in the greater Atlanta area. Cohort C (NCT00135226; PI: WW) was a cohort of middle-aged to older white ( n = 47) and Black participants with NC ( n = 21) who underwent detailed prospective baseline and longitudinal neuropsychological, CSF, and MRI characterization for identifying effect of race on vascular and AD biomarkers 9 , 39 . Participants in this study were recruited from the Emory Alzheimer’s Disease Research Center, community events, or dementia caregiving groups in the greater Atlanta.…”

Alzheimer disease in African American individuals: increased incidence or not enough data?

“…Similar to the lack of neuropathology data from African American individuals, few AD biomarker studies have been performed in this population and the results have been mixed. To date, all cerebrospinal fluid (CSF) AD biomarker studies, including those performed in participants without AD or mild cognitive impairment (MCI), have found lower levels of phosphorylated tau 181 and total tau 62 – 65 in African American individuals than in white individuals. However, studies of plasma and PET biomarkers in participants with and without AD found no difference in levels of tau between African American individuals and white individuals 66 – 68 .…”